A 500 results when creating a handler that writes an image buffer to the output:
exports.handler = function (event, context, callback) {
var outputBuffer = // ... image buffer stuff
var response = {
    statusCode: 200,
    headers: {'Content-Type' : 'image/png'},
    body: outputBuffer.toString('base64'),
    isBase64Encoded: true
}
callback(null, response)
}